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2020 [v1] PAGE [1] of 2ACCIDENTAL DEATH CLAIM FORM Underwritten by Constancia Insurance Company Limited (CIC), Reg. No. 1952/001514/06, FSP No: 31111 (The Insurer)CLAIMING PROCEDURES Please complete
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How to fill out accidental death and dismemberment
How to fill out accidental death and dismemberment
01
Obtain a claim form from your insurance provider or employer.
02
Fill out the insured person's information such as name, address, date of birth, and policy number.
03
Provide details of the accident including the date, time, and location.
04
Describe the injuries sustained in the accident and provide any relevant medical records or reports.
05
Include any supporting documentation such as police reports or witness statements.
06
Sign and date the claim form before submitting it to the insurance provider.
Who needs accidental death and dismemberment?
01
Accidental death and dismemberment insurance is recommended for individuals who have dependents or beneficiaries who would suffer financially in the event of their death or serious injury.
02
Those in high-risk professions or who participate in hazardous activities may also benefit from having accidental death and dismemberment coverage.
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What is accidental death and dismemberment?
Accidental death and dismemberment (AD&D) is a type of insurance policy that pays benefits to the beneficiary if the insured dies or loses a limb or eyesight due to an accident.
Who is required to file accidental death and dismemberment?
The beneficiary or the insured's representative is typically required to file the accidental death and dismemberment claim.
How to fill out accidental death and dismemberment?
To fill out an accidental death and dismemberment claim, the beneficiary or representative must provide the necessary documentation, such as a death certificate or medical records.
What is the purpose of accidental death and dismemberment?
The purpose of accidental death and dismemberment insurance is to provide financial protection to the insured's beneficiaries in case of an accidental death or injury.
What information must be reported on accidental death and dismemberment?
Information such as the insured's personal details, the circumstances of the accident, medical reports, and any other relevant documentation must be reported on an accidental death and dismemberment claim.
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